Cysto trays

[RNSHAMBLS]

I am having issues with my cysto instruments. We are attempting to reduce our flashes, and cysto trays are one of our biggest problems. Our cysto nurse says that many hospitals still only soak their cysto instruments, so flashing them is really not an issue. I am trying to get her in invest in a couple more sets of instruments so that we can eliminate having to flash them at all.

How do other hospitals handle their cysto instruments? I feel that even tho cystos are considered clean, not sterile, they should be treated like any other instruments and be fully processed.

Any ideas where I can find standards on cysto instrumentation?

[Sno]

Our facility has 6 sets of Cysto and Resectoscope instruments. I know this is a large amount but we no longer flash and the doctors love it.

[allis]

From what company are your cysto trays RN and Sno? I have cysto trays from Olympus, Storz and ACMI. I use STERRAD to sterilize them, and everything has always been fine. By policy we never flash any cysto tray. We never have the need to do that either. The preferred cysto tray in my facility is from ACMI,(New Elite) and we have almost 20 of them, plus 15 Resectoscope Trays.
P.S. By the way, does Circon ACMI belong to Olympus?

[RNSHAMBLS]

We use Olympus & have 5 sets. The problem is some days we do 10 cystos, plus we have a couple GYN docs who also do cystos in open rooms when they do certain procedures. We can't seem to keep them processed fast enough to avoid flashing. Administration has approved buying 3 more sets which would eliminate the need to flash. I just need to convince out cysto nurse we need more (she'd rather purchase other equipment and continue flashing cysto trays0.

[Sno]

You can show your cysto nurse the AORN guidelines that say flashing is not a good substitute for lack of buying more instruments. Our trays our Olympus and we steam them. We do sterrad the cameras and ETO the flexible scopes. I am waiting for Olympus to recommend sterrad nx for their scopes before we purchase the NX. We have purchased Stryker Hysteroscopy instruments and their cysto components for the GYN docs. We had ACMI but they are very old and we have since replaced with Olympus or Stryker.

[jrc]

Please tell me your hospital does not soak cysto instruments in OPA! Johnson and Johnson has come out with instructions saying not to do so because it is contraindicated for patients with bladder cancer (a good portion of the cysto patients).

As far as flashing, Sno had a great suggestion. Show the cysto nurse AORN's recommendation. Beyond that, you can go to your infection control and risk management professionals at your hospital. Enlisting their aid can sometimes lend more weight to your cause.

The only recommendations regarding the specific instruments would be those from the manufacturers. Agencies such as AAMI and AORN usually tend to stay away from tackling specific types of instruments.

[RNSHAMBLS]

We haven't soaked instruments in years, but our cysto nurse insists some hospitals still do.

[rometta kennedy]

We had to buy more cysto insts to keep up with demand. When state inspectors come they are very concerned about how much is being flashed, so we don't flash cysto insts anymore.

[howardg]

We had this issue for many years. We started out with about six cysto trays. At that time we were turning them over all day. The hospital purchased Steris Machines and that is what we used to "sterilize" the cysto trays. This was before we upgraded out rigid cystoscopes so that they could be steam sterilized.

We currently have 12 cysto trays. We have purchased a Sterrad machine to assist in the turnover and hardly ever use the Steris machine. One thing that we do is when a cysto case comes out we have a tech that will decontaminate, assemble and package the cysto tray for steam sterilization and then send to SPD to be resterilized. This cuts down in "flash" cycles and it gives every patient the same type of care.

[jerilyn]

I agree "One thing that we do is when a cysto case comes out we have a tech that will decontaminate, assemble and package the cysto tray for steam sterilization and then send to SPD to be resterilized. This cuts down in "flash" cycles and it gives every patient the same type of care." This is how we do our's we call it fast turn-a-round. We track flashing and we almost never flash any more. We have the Cysto USA Elite sets.
Flashing should never be used unless except as a last resource.

[wperez]

I am having issues with my cysto instruments. We are attempting to reduce our flashes, and cysto trays are one of our biggest problems. Our cysto nurse says that many hospitals still only soak their cysto instruments, so flashing them is really not an issue. I am trying to get her in invest in a couple more sets of instruments so that we can eliminate having to flash them at all.

How do other hospitals handle their cysto instruments? I feel that even tho cystos are considered clean, not sterile, they should be treated like any other instruments and be fully processed.

Any ideas where I can find standards on cysto instrumentation?

I agree purchase additional trays and reduce flashing. Get infection control involved. We just had a Joint commission visit and ther looked at the amount of flashing done in the OR and why. They wanted to know what we were doing to reduce flashing.

[libra]

We have Olympus and ACMI sets and we fully process them. You might also want to tell them that JCAHO also looks at flash records and why they are being flashed.